Ultrasonic dental and other instrument means and methods

ABSTRACT

The invention discloses various ultrasonic dental equipment primarily adapted to be used for professional dental purposes as well as various dental procedures capable of being performed with the ultrasonic instrumentation. The ultrasonic dental system permits the user to selectively utilize a variety of fluids within the oral hygenic procedures carried out by the dentist. The fluids may be selective medicaments that are pumped through the dental system from either an external source i.e., water, to various other fluids each for its intended usage. The invention discloses motor-convertor systems in which a single piezoelectric crystal element is used to both simultaneously drive an ultrasonic motor and provide a feedback signal for frequency sensing means to permit the convertor to adjust itself thereto.

AU 335 EX United States Patent on 3,924,335 Balamuth et al. 1 Dec. 9,1975 [54] ULTRASONIC DENTAL AND OTHER 3.7mm 11/197: Robinson 32/DIG. 4INSTRUMENT MEANS AND METHODS 3.809.977 5/1974 Balamuth et al 32/58 Xinventors: Lewis Balamuth, New York; Arthur Kuris, Riverdale; ManuelKaratjas, Glen Oaks, all of N.Y.

Ultrasonic Systems, Inc., Farmingdalc, N.Y.

Filed: Dec. 20, 1971 Appl. No.: 209,971

Related US. Application Data Continuation-impart of Ser. No. ll9,298,Feb. 26, 197i, Pat. No. 3,809,977.

Assignee:

US. Cl. 32/58; 32/DlG. 4; 128/24 A; 3l0/8.l

Int. CL... A61C 3/06; A61H l/OO; HOlV 7/00 Field of Search 32/26, 27,DlG. 4, 58; l28/24 A; 3l0/8.l, 26

References Cited UNITED STAllzS PATENTS lO/l965 Balamuth et al 32/DlG. 4

Primary livuminer-Robert Peshock Assistant Examiner-J. Q. Lever [57]ABSTRACT The invention discloses various ultrasonic dental equipmentprimarily adapted to be used for professional dental purposes as well asvarious dental procedures capable of being performed with the ultrasonicinstrumentation. The ultrasonic dental system permits the user toselectively utilize a variety of fluids within the oral hygenicprocedures carried out by the dentist, The fluids may be selectivemedicaments that are pumped through the dental system from either an ex-I ternal source i.e., water, to various other fluids each for itsintended usage.

The invention discloses motor-converter systems in which a singlepiezoelectric crystal element is used to both simultaneously drive anultrasonic motor and provide a feedback signal for frequency sensingmeans to permit the convertor to adjust itself thereto.

31 Claims, 32 Drawing Figures U.S. Patent Dec.91975 Sheet1of16 3,924,335

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US. Patent Dec.91975 Sheet2of 16 3,924,335

U.S. Patent Dec.91975 Sheet30f16 3,924,335

U.S. Patent 1960.91975, Sheet40f16 3,924,335

US. Patent Dec.91975 Sheet5ofl6 3,924,335

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US. Patent Dec.91975 Sheet6of 16 3,924,335

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US. Patent Dec.91975 Sheet7ofl6 3,924,335

U.S. Patent Dec.91975 Sheet110f16 3,924,335

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US. Patent Dep.91975 Sheet 12 of 16 3,924,335

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US. Patent Dec.91975 Sheet 14 of 16 3,924,335

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ULTRASONIC DENTAL AND OTHER INSTRUMENT MEANS AND METHODS CROSS-REFERENCETO RELATED APPLICATION This application is a continuation-in-part of ourcopending application Ser. No. 119,298 filed Feb. 26, 1971 now U.S. Pat.No. 3,809,977 issued May 7, 1974, entitled ULTRASONIC KITS AND MOTORSYS- TEMS, which entire subject matter of the copending application isincorporated herein by reference as if fully herein set forth.

BACKGROUND OF THE INVENTION The present invention relates to anultrasonic unit adapted to be used primarily for professional dentalapplications to perform a variety of functions and procedures as well asthe system designed therefore.

Heretofore, the use of ultrasonic energy in dentistry for professionalpurposes has been limited to the use of water as the fluid utilizedwithin dental prophylaxis procedures in order to remove foreignsubstances from within the oral cavity and perform other dental procedures. The present inventors have now discovered that a host of dentalprocedures not heretofore available may be realized by a system thatpermits dentists to select fluids having various chemical formulationssuch that both physical and psychological benefical results areobtained.

Accordingly, by the provision of interchangeable and replaceable fluidsupply sources that can be directed through the ultrasonic dentalhandpiece, the scope and variety of dental techniques are increased to aconsiderable extent. It might be stated that this additional flexibilitygiven to the dentist permits a number of dental procedures to be carriedout that were heretofore not practicable.

By way of background, the use of Kilohertz ultrasonic energy in thedentists office has become commonplace, chiefly due to the pioneeringwork of the inventors of the present invention. For example, a dentaloperative unit is currently widely used by dentists for a great varietyof procedures including:

1. Drilling of teeth 2. Periodental gingival-tooth careMesztcazaithszraey 4. Amalgam Packing 5. Orthodontic aids in shapingteeth and in removing dental cements from braces 6. Surgical proceduresrelated to gingivectomy and endodontic procedures 7. Gingival massageand tooth cleaning Now, the inventors, having been involved in thehistorical growth of these techniques and procedures, have carefullyfollowed and evaluated the changing requirements which improvedultrasonic dental equipment should embody. In this patent, such novelimproved equipment and new techniques will be disclosed in theirappropriate places.

In the first place, advances in the electronic art combined withadvances in the technology of transducer materials, now permit the useof simplified solid state circuitry and more efficient transducermaterials, so that better generators and handpieces are possible. In thecase of transducer materials, both ferromagnetic and ferroelectricceramics have reached a quality resulting in high conversion efficiency,high and low temperature stability, and a long, relatively non-aging 2product life. These factors are partially reflected in one of theinventors US. Pat. No. 3,547,l 10. in the field of dentistry.

Now, at the same time, the inventors have been involved as a part of arapidly expanding aspect of the ultrasonic art in the biological,chemical and medical fields. It is the intention of this disclosure toshow how the technological ultrasonic motor-converter advances. outlinedabove, may be combined with the uses of ultrasonic effects in thebio-medical areas to produce a unique novel professional dentalinstrumentation to carry out a wide variety of procedures. Two of thepresent inventors have already pioneered in the development ofultrasonic instrumentation, which has resulted in world-wide acceptanceof most of the procedures outlined above.

One of the most important novel features of the present dentalinstrumentation is the provision of readily interchangeable reservoirsof fluid medicaments for specialized professional dental uses. For,example, thepresent unit employs a twoway hydraulic system, whichpermits the use of either a regular ordinarly available outside watersupply, or an internal hydraulic system, utilizing a fluid supply tankwhich is removably attachable to the professional dental unit itself.

Now, when the internal hydraulic system is intended for use by thedentist (or oral hygienist), the operator merely sets the appropriatecontrol and attaches a ster ile plug-in source of desired medicamentfluid into the place provided in the equipment. All this is of coursedescribed in detail as the disclosure proceeds. In order to understandbetter the problems which must be solved to allow this novel procedure,one example will be given. U

The removal of calculjs from gingival and subgingival hard toothsurfaces (dentin and enamel) is one of the chief problems facing theperiodontist in treating the undesireable conditions found in the mouth,and is essential for maintaining and restoring good dental health. Achemical solution is often used which selectively stains plaque andcalculus and thereby assists the dentist in determining the thoroughnessof a given prophylactic oral treatment. Such a solution is called adisclosing solution. In the applicants subject dental unit, one of theself contained medicament fluid containers may contain such a disclosingsolution and may be conviently stored away from the unit until it isdesired by the dentist for use. Now, if he has used such a procedure,the internal hydraulic system of the unit will have its various tubesand conduits filled with said disclosing solution. If the dentist wishesfor example to use plain water, or a different medicament solution forhis next patient, or even for the same patient, it is essential to beable to clean out the internal hydraulic system completely so that is isreplaced with clear, clean water. As will be disclosed completely in duecourse, the present invention provides precisely the means needed toaccomplish this purpose, and as will be appreciated this is anothernovel aspect of the present invention.

Additionally, the present invention prefers to use piezoelectric ceramictransducers, because of the high efficiency and great ease infabrication of motors made with such materials, althoughmagnetostrictive transducers may also be used.

Also, theinventors have been aware of the need to provide quick changeoperating hand instruments as compared to certain prior art inventionsof providing magnetostrictive laminated stack inserts, which tele- 3scope into a handpiece which comprised a coil winding and a thininsulation jacket. Although quite safe, the thin insulator plasticjacket nevertheless required the operator to grasp the jacket in thearea where the coil was wound.

In the present invention the concept of removably detachable insert isnot necessarily relied on and in its place there has been substituted aremovably detachable handpiece. The handpiece merely unplugs and replugsinto a small receptacle terminating into the cable, which connects saidreceptacle and the output means of the converter system.

This simple, yet novel, transformation of the converter ultrasonic motorconnector means introduces another new dimension into the instantinvention. This is because the excitation of the motor does not dependupon a fixed coil, which in turn, must always engage a seperate insertproperly in order for the dental instrument to function as designed Forexample whereas the magnetostrictive insert type of motor is restrictedto the driving coil in the handpiece means, the detachable motor of thepresent invention may be changed to any type of piezoelectric ormagnetostrictive self contained motor designed to operate at theimpedance level of the converter output. And in fact, the converteroutput may be readily provided with a tapped output means, whereby anumber of different impedances may be available for use. Thus, theoutput design of the present invention provides a versatility not foundin the prior art.

MOTOR-CONVERTOR SYSTEM The present invention also relates to anultrasonic motor-converter system in which the piezoelectric crystal isused for both driving the motor and producing a feed-back signal.

Heretofore, the ultrasonic motor art has developed in that piezoelectricelement or crystals have been utilized for powering the ultrasonic motorand exciting the motor at a desired frequency range. In the abovereferenced co-pending patent application there is disclosed theutilization of a driving crystal or crystals for powering the ultrasonicmotor and a feed-back or third crystal element adapted to be used forthe purpose of providing a signal feed-back which is transmitted to theconvertor and which signal is utilized by the convertor to adjust thefrequency of the convertor system in respect thereto.

Although, motors of the aforementioned design in the co-pendingapplication produce the requisite capacity of withstanding the necessarywork-loads, it has been found that the utilization of two or threecrystals require a number of related machined component parts that haveto be assembled in proper relationship to each other, each one adding tothe cost of the completed motor. Furthermore, a major portion of thiscost being the crystal material itself. Accordingly, in order to obtainan economical motor, i.e., one adaptable for home-consumer and otheruse, it has been considered that it would be advantageous if thebenefical effects of an ultrasonic motor could be produced in which thedriving and sensing were incorporated in a single crystal so that thenumber of component parts would be substantially reduced. This noveldesign of an ultrasonic motor incorporating a single crystal element isherein disclosed.

OBJECTS OF THE INVENTION The object of the invention is to provide newand improved dental procedures utilizing ultrasonic energy.

Another object of the invention is to provide new and novel dentalprocedures having both physical and pyschological effects on thepatient.

Another object of the present invention is a new and novel dental systempermitting the selective utilization of medicaments within the cleaningprocedure.

Another object of the invention is to provide a novel motor-convertorsystem in which a single piezolectric element may be utilized for bothdriving the motor and generating a feed-back signal to the convertor.

. Another object of the present invention is to provide individualcontainers for the supplying of the medicaments for use in conjunctionwith the dental system.

Other objectives of the invention will be apparent as descriptionproceeds.

SUMMARY OF THE INVENTION The present invention provides for a series ofnovel interrelated steps in combination with each other to obtain dentalprocedures not heretofore obtainable with the prior art.

In accordance with one aspect of the present invention a system isprovided that permits the dentist, or other user, for the first time tobe able to select a source of fluid in a dental procedure from a closedsystem or from conventional water supply. The ability to permit adentist to operate at will from either a closed system or open systempermits the dentist to utilize a series of medicaments that may beprovided in sealed containers and plugged into the dental system forperforming various applications.

The apparatus in accordance in one aspect of the invention, includes amotor-convertor system in which the motor contains a piezoelectricmaterial which is formed as to provide longitudinal ultrasonicvibrations when it is activated by high-frequency electrical impulsesand the resultant ultrasonic vibrations are transmitted through themotor to the point of use. A portion of the crystal is isolated andelectrically converted such that a feed-back signal is generated thereinand in turn the electrical signal is transmitted to the convertor inorder to properly adjust itself to the frequency at which the motor isvibrating.

In accordance with one aspect of the invention the crystal utilized isof tubular configuration. The crystal is so fonned as to providelongitudinal ultrasonic vibrations when it is activated byhigh-frequency electrical impulses and the resultant ultrasonicvibrations are transmitted by the tip to the point of use. The crystalutilized is of tubular configuration made preferrably of lead zirconateand/or leadtitanate ceramic material which is so formed that it has thequality of expanding and contracting longitudinally at ultrasonicfrequencies and is joined end to end to the tip by an epoxy cement orother means so that the ultrasonic tip movements are directly related tothe longitudinal expansion and contraction of the activated crystal.While the later may be designed to operate at frequencies from 25,000c.p.s. to 45,000 c.p.s., for dental applications such frequenciesusually will not exceed this frequency, the crystal and attached tipconstitute a matched pair and form said component resonator. Provisionis made in the handpiece for supporting and retaining the crystal andtip. In addition, a water duct in conjunction with the handpiece and tipis provided for a stream of water from the tip during use.

In accordance with another aspect of the invention a series of novelreceptacles are disclosed which are prefilled on a commercial basis andacquired by the dentist for use in conjunction with apparatus definedherein. The receptacles are designed such that they may besimultaneously vented and may have a valve mounted thereon which valvemeets with an accompanying valve seat on the unit such that the fluidcontained in the closed reservoir or container may be pumped through thesystem and used by the dentist.

In accordance with another aspect of the invention a flushing procedureis provided such that the user may cleanse the complete dental systemwith water when switching from one type of medicament to another. Thisaspect of the invention is unique to the provision of a system in whicha variety of different fluids may be introduced, some of which may notbe compatable with each other, or just merely the fact that the nextpatient should not be subjected to the fluid of the previous patient.Thus, the system has a built-in flushing cycle to permit the necessaryflushing thereof.

BRIEF DESCRIPTION OF THE DRAWINGS Although the characteristic featuresof this invention will be particularly pointed out in the claims, theinvention itself, and the manner in which it may be made and used, maybe better understood by referring to the following description taken inconnection with the accompanying drawings forming a part hereof, whereinlike reference numerals refer to like parts throughout the several viewand in which:

FIG. 1, is a perspective view of an ultrasonic dental system in use;

FIG. 2, is a front elevational view of ultrasonic instrument means foruse in the present invention;

FIG. 3, is a side elevational view partially in crosssection of theinstrument means of the present invention;

FIG. 4, is an enlarged sectional view of the reservoir relationship;

FIG. 5, is a side elevational view of ultrasonic instrument means foruse in the present invention;

FIG. 5A, is a side elevational view in cross-section of the instrumentmeans in assembled relationship taken along a medial plane;

FIG. 5B, is a view in cross-section taken along the plane indicated bythe line 58 5B in FIG. 5A;

FIG. 5C, is a view in cross-section taken along the plane indicated bythe line 5C SC in FIG. 5A;

- FIG. 5D, is an enlarged view in cross-section of the assembled end ofthe crystal;

FIGS. 6 6D are similar to FIGS. 5 5D and illustrate another embodimentof the invention;

FIGS. 7 and 8 are enlarged partial views illustrating another form ofsensing means in accordance with the present invention;

FIG. 9, is a side elevational view in cross-section of a novelcontainer;

FIGS. 9A and 9B, are enlarged views in cross-section illustrating otherforms for sealing the container;

FIG. 10, is a view illustrating the assembled relation of the containerand instrument means;

FIG. 11, is a diagrammatic view illustrating the relative components;

FIGS. 12 16, are schematic more or less diagrammatic views of thehydraulic system of the invention during its various stages ofoperation:

FIG. 17, is a view similar to FIG. 12 illustrating the use of two ormore receptacles;

FIG. 18, is a view similar to FIG, 13 illustrating another hydraulicelectrical system;

FIGS. 19 and 20, are a front and side elevational views, respectivelypartly in section, of the dental system containing a plurality ofreservoir; and

FIGS. 21 and 22, illustrate various electrical schematics of convertersthat can be used to drive the various ultrasonic motors describedherein.

PREFERRED EMBODIMENTS OF THE INVENTION Turning now to the drawings FIGS.14 have disclosed an ultrasonic system generally indicated by referencenumeral 10 for use by an individual 11, that may be a dentist or othertrained person, using the equipment 10 on a patient 12 seated on a chair13, as for example a dentist using the equipment for dental prophylaxispurposes. The equipment is seen to include a cabinet 14 on a table orother support 16, which contains therein an ultrasonic converter 15, aswell as a tray or reservoir 20 on the top 18, and containing a supply ofa fluid 22, which in conventional manner, is pumped from a reservoir 20,by a pumping means 25 (see FIG.

4) contained within the cabinet 14.

Ultrasonic instrumentation means 26 is coupled to the converter means 15and the pumping means 25 by a cable means 28 which contains a currentsupply line 59 and a fluid conduit 167. The ultrasonic equipmentincludes an accessory implement means 30 that may have various shapesand configurations, and adapted to be removably secured to the adapteror the coupling means 35.

The cabinet 14 contains power-control means in the form of a switch 36having ON and OFF positions and a variable switch 38 to regulate thepower of the converter 15. An indicator light 40 is provided on thefront panel 32 of the cabinet 14 to indicate when the switch 36 is inits ON position. A fluid selector switch 42 is provided on the frontpanel 32 and provides a selection of either the internal fluid supply orthe external supply such that, as herein described, the user has theflexibility of using the instrumentation 10, from an external watersupply or an internal fluid supply which permits him to use a host ofliquids to perform a number of dental procedures. The fluid regulatormeans 41 includes a fluid regulator 45 that contains a dial 46 to varythe rate of the pumping means 25 when the fluid selector switch 42 is onits internal position, and which pumps the fluid from the reservoir 20through the cable 28 in a manner which is well known in the art. Whenthe fluid selector switch 42 is in the external position, then the fluidregulator switch 45 acts to control the liquid flow from the externalfluid supply so that the amount of fluid being transmitted through theinstrumentation means 26 is controlled as well as the degree ofvibrations of the tip thereof by the proper control of the variousrelated switches of the front panel 32 on the cabinet 14.

The cabinet 14 is seen to include support means 50, which may extendfrom the side wall 52 thereof in the form of an arm 54 supporting abracket 55 having a recess or seat 56 extending on an angle therewithsuch that the assemblied accessory means 30 and adapter

1. An ultrasonic dental system including A. a converter for providingelectrical current at an ultrasonic rate, B. an accessory having a tipfor use in the oral cavity when ultrasonically vibrated, said accessoryincluding
 1. housing means,
 2. a transmission member having a rearsection and a front section, said front section extending beyond saidhousing and having said tip secured thereto,
 3. transducer meansconnected to said section for driving said transmission member, and 4.means to suply a fluid to said tip, C. means electrically connectingsaid converter to said transducer means in said accessory, D. fluidregulating means communicating with said accessory means to supply afluid to said tip, E. internal fluid supply means including dispensingmeans adapted to be coupled with a liquid reservoir communicating withsaid fluid regulating means to provide an internal supply of liquid tothe accessory, F. external fluid supply means communicating with saidfluid regulating means to provide an external supply of liquid to theaccessory, G. control means communicating with said fluid regulatingmeans for permitting selection of fluid from said internal fluid supplymeans or said external fluid supply means, H. liquid reservoir meansadapted to be readily engaged with said dispensing means to permit theutilization of a variety of fluids within the oral hygienic proceduresto be conducted with the dental system, and I. means for flushing saidinternal supply means with fluid from said external supply means.
 2. atransmission member having a rear section and a front section, saidfront section extending beyond said housing and having said tip securedthereto,
 2. An ultrasonic system as defined in claim 1, and furtherincluding means for flushing the dental system from said regulatingmeans through said accessory.
 2. pumping the fluid through saidinstrument, and
 2. housing means enclosing said motor, and
 3. electricalconnecting means associated with said housing means and connected tosaid motor, said housing means adapted to be releasably connected tosaid adapter for the transmission of electrical energy to said motorwhen in its assembled position, and I. fluid regulating meanscommunicating with said liquid reservoir means and accessory means tosupply the fluid in said reservoir to said tip at a selected rate.
 3. Anultrasonic system as defined in claim 1, and further including: a. anadapter coupled to said converter for transmission of said electricalenergy, b. a cabinet housing said converter c. support means for holdingsaid adapter in fixed position relative to said cabinet when not in use,and d. a plurality of accessories each adapted to be interchangeablewith and releasabley connected to said adapter.
 3. transducer meansconnected to said section for driving said transmission member, and 3.regulating the rate of pumping of said fluid through the instrument, andC. simultaneously transmitting to the selected structure mechanicalvibratory energy in the ultrasonic frequency range by means of said tipdirectly placed in energy transmission relationship to said structure,whereby said fluid has a beneficial effect on the patient as saidtreatment is obtained by transmitting ultrasonic energy to the treatedstructure through substantial direct engagement of said tip and throughthe liquid medium of said stream.
 4. means to suply a fluid to said tip,C. means electrically connecting said converter to said transducer meansin said accessory, D. fluid regulating means communicating with saidaccessory means to supply a fluid to said tip, E. internal fluid supplymeans including dispensing means adapted to be coupled with a liquidreservoir communicating with said fluid regulating means to provide aninternal supply of liquid to the accessory, F. external fluid supplymeans communicating with said fluid regulating means to provide anexternal supply of liquid to the accessory, G. control meanscommunicating with said fluid regulating means for permitting selectionof fluid from said internal fluid supply means or said external fluidsupply means, H. liquid reservoir means adapted to be readily engagedwith said dispensing means to permit the utilization of a variety offluids within the oral hygienic procedures to be conducted with thedental system, and I. means for flushing said internal supply means withfluid from said external supply means.
 4. An ultrasonic system asdefined in claim 1, and wherein said transducer means includes a portionthereof for driving said member and an electrically insolated protionthereof for sensing variations in frequency of said motor and regulatingthe alternating field of said converter to the corresponding frequency.5. An ultrasonic system as defined in claim 1, and further includingpumping means communicating with said internal fluid supply means forpumping fluid from said reservoir to said fluid regulating means.
 6. Anultrasonic system as defined in claim 1, wherein said fluid is suppliedthrough said tip.
 7. An ultrasonic system as defined in claim 1, whereinsaid fluid is supplied adjacent said tip.
 8. An ultrasonic system asdefined in claim 1, and further including hydraulic system meansincluding: a. a first valve having input and output ports, said inputport adapted to be connected to said external source of fluid supply, b.a second valve having input and output ports, c. conduit member havingtwo input ports and an output port, one of said input ports beingcoupled to said output port of said first valve, the other of said inputports being coupled to said output port of said second valve, saidoutptut port being coupled to said means to supply a fluid to said tipthrough said fluid regulating means, and d. a fluid pump having a fluidchamber therein with an input and output port, said output port beingcoupled to said second valve input port, said pump being adapted to beoperator activated, and forming part of said internal fluid supply meansand coupled to said reservoir.
 9. An ultrasonic system as defined inclaim 8, and further including operator activated control and selectorswitch means coupled to said control valves and said pumping means forproviding external fluid operation, internal fluid operation, flushingoperation, and priming operation.
 10. An ultrasonic dental systemincluding A. a cabinet, B. a converter for providing electrical currentat an ultrasonic rate contained within said cabinet, C. an adaptercoupled to said converter for transmission of said electrical energy, D.support means for holding said adapter in fixed position relative tosaid cabinet when not in use, E. a plurality of accessories each adaptedto be interchangeable with and releasably connected to said adapter andhaving a dental tip at one end thereof, F. dispensing means forretaining a reservior in fixed position relative to said cabinet whenthe dental system is in use, and G. removable liquid reservoir meansadapted to be readily engaged with said dispensing means in associatedrelationship with said cabinet and communicating with said adapter toprovide an internal supply of liquid to the accessory, H. saidaccessories each including:
 11. An ultrasonic system as defined in claim10, wherein said dental tip is adapted to be removably secured to saidaccessory for transmission of the ultrasonic mechanical vibrations. 12.An ultrasonic system as defined in claim 10, and further including: a.external fluid supply means communicating with said fluid regulatingmeans to provide an external supply of liquid to the accessory, and b.control means communicating with said fluid regulating means forpermitting selection of fluid from said internal reservoir means or saidexternal fluid supply.
 13. An ultrasonic system as defined in claim 12,and further including means for flushing said internal fluid supplymeans with fluid from said external fluid supply means.
 14. Anultrasonic system as defined in claim 12, and further including meansfor flushing the dental fluid from said external Fluid supply means. 15.The method of treating the gingival and tooth structures of the oralcavity for hygienic control thereof, with an ultrasonic dentalinstrument having a tip adapted to be inserted within the oral cavity,comprising the steps of: A. inserting said tip within the oral cavity,B. supplying to said tip a stream of medicinal fluid for treatment ofthe gingival or tooth structures from an internal fluid supply thatpermits the selection and control of said fluid, and wherein said stepof supplying to said tip a medicinal fluid includes:
 16. The method asdefined in claim 15, and further including the step of flushing saidarea treated with said medicinal fluid with another fluid.
 17. Themethod as defined in claim 15, wherein said medicinal fluid is ananalgesic.
 18. The method as defined in claim 15, wherein said medicinalfluid is fluoride.
 19. The method as defined in claim 15, wherein saidtreatment is conducted subgingivly.
 20. The method as defined in claim15, wherein said fluid is of a red color.
 21. The method as defined inclaim 15, wherein said fluid is provided through said tip.
 22. Themethod as defined in claim 15, wherein said fluid is provided adjacentsaid tip.
 23. The method as defined in claim 15, wherein said medicinalfluid is a plaque dye.
 24. The method as defined in claim 15, whereinsaid medicinal fluid is an anti plaque solution.
 25. The method asdefined in claim 15, and further including the step of controlling theamplitude of vibration of the dental tip by regulating the electricalpower delivered thereto.
 26. The method as defined in claim 15, andfurther including flushing the dental instrument with fluid from theexternal source after completing the treatment.
 27. The method oftreating the gingival and tooth structures of the oral cavity forhygienic control thereof, with an ultrasonic dental instrument having atip adapted to be inserted within the oral cavity, and capable ofsupplying fluid from either an external source, or an internal sourcewhich is selectable by the user of the instrument, A. providing aninternal source of fluid in a plurality of independent reservoirs, B.selecting a medicinal fluid to be applied in said oral cavity from oneof said reservoirs, C. coupling the selected reservoir to the dentalinstrument, D. inserting said tip within the oral cavity, E. pumping thefluid for supplying to said tip said fluid for treatment of the gingivalor tooth structures from said internal fluid supply, and F.simultaneously transmitting to the selected structure mechanicalvibratory energy in the ultrasonic frequency range by means of said tipdirectly placed in energy transmission relationship to said structure,whereby said fluid has a beneficial effect on the patient as saidtreatment is obtained by transmitting ultrasonic energy to the treatedstructure through substantial direct engagement of said tip and throughthe liquid medium of said stream.
 28. The method as defined in claim 27,and further including the step of regulating the rate of pumping of saidfluid through the instrument.
 29. The method as defined in claim 27, andfurther including the step of controlling the amplitide of vibration ofthe deNtal tip by regulating the electrical power delivered thereto. 30.The method as defined in claim 27, and further including flushing thedental instrument with fluid from the external source after completingthe treatment.
 31. The method as described in claim 27, and furtherincluding the step of flushing said areas treated with said medicinialfluid with another fluid.